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Myeloproliferative Disorders and the Chronic Leukemias: Symptom Burden and Impact in Quality of Life

  • R. A. Mesa
  • D. P. Steensma
  • T. Shanafelt
Reference work entry

Abstract:

Optimizing health-related quality of life (QOL) is an important goal for patients with any hematological malignancy, but for those who suffer from disorders that follow a relatively indolent yet refractory course, QOL is an especially prominent consideration. These latter conditions include the chronic myeloproliferative disorders (MPD), myelodysplastic syndromes (MDS), and chronic lymphocytic leukemia (CLL) – diseases that are rarely curable, but that are often associated with prolonged survival. The MPD include polycythemia vera, essential thrombocythemia, and myelofibrosis (which can be primary, or can arise during the course of polycythemia vera or essential thrombocythemia). MPD-associated symptoms that compromise QOL include pruritus, night sweats, unintentional weight loss, loss of lean muscle mass, and profound fatigue, while QOL-impairing complications include thrombosis, bleeding, and often-dramatic splenic enlargement. Likewise, MDS suffer symptoms related to cytopenias, and CLL patients must contend with cytopenias, complications related to adenopathy and splenomegaly, and “B symptoms” (night sweats, weight loss, and unexplained fevers). By directly surveying large cohorts of MPD, MDS, and CLL patients using validated QOL instruments, we demonstrated that the burden of symptoms in these patients is severe, and that excessive fatigue is the most common and troublesome symptom of all, far exceeding levels reported for matched disease-free controls in the general population. Management of patients with MPD, MDS, or CLL needs to take into consideration QOL issues, and clinical trials of therapeutic agents should include improved QOL as a valid treatment endpoint.

Keywords

Chronic Lymphocytic Leukemia National Comprehensive Cancer Network Polycythemia Vera Essential Thrombocythemia Chronic Lymphocytic Leukemia Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations:

BFI

Brief Fatigue Inventory

CLL

Chronic Lymphocytic Leukemia

CMML

Chronic Myelomomonocytic Leukemia

ESA

Erythropoietin Stimulating Agent

ET

Essential Thrombocythemia

FACTG

Functional Assessment of Cancer–General

FDA

Federal Drug Administration

MDS

Myelodysplastic Syndrome

MPD

Myeloproliferative Disorder

PV

Polycythemia Vera

Post ETMF

Post Essential Thrombocythemia Myelofibrosis

Post PVMF

Post Polycythemia Vera Myelofibrosis

PMF

Primary Myelofibrosis

QOL

Quality of Life

RA

Refractory Anemia

RAEV

Refractory Anemia with Excess Blasts

RAEV-T

Refractory Anemia with Excess Blasts in Transformation

RARS

Refractory Anemia with Ringed Sideroblasts

RCMV

Refractory Cytopenia with Multilineage dysplasia

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Copyright information

© Springer Science+Business Media LLC 2010

Authors and Affiliations

  • R. A. Mesa
  • D. P. Steensma
  • T. Shanafelt

There are no affiliations available

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